%0 Journal Article
%T Prostate biopsy sepsis prevention: external validation of an alcohol needle washing protocol.
%A Hiffa A
%A Chen M
%A Boghani F
%A Oberle MD
%A Reed WC
%A King SA
%A De Caro J
%A Terris MK
%A Simmons MN
%A Dykes TE
%J World J Urol
%V 42
%N 1
%D 2024 May 1
%M 38693444
%F 3.661
%R 10.1007/s00345-024-04955-w
%X <B>OBJECTIVE: </B>Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is associated with a 1-8% risk of post-biopsy sepsis (PBS). A recent study described an isopropyl alcohol needle washing protocol that significantly decreased PBS rates. The current study examined the efficacy of this technique in our clinic population.<BR><B>METHODS: </B>Data were reviewed for 1250 consecutive patients undergoing TRUS-Bx at the Charlie Norwood VA Medical Center from January 2017 to January 2023. Needle washing was adopted in February 2021. Complications occurring within 30 days after TRUS-Bx were recorded.<BR><B>RESULTS: </B>There were 912 patients in group 1 (without needle washing) and 338 in group 2 (with needle washing). Groups had equivalent demographic features, and men of African descent comprised 70% of patients. Standard 12 core biopsies were done in 83% and 82% in groups 1 and 2, respectively (p = 0.788). Total complication rates were 4% and 2% in groups 1 and 2, respectively (p = 0.077). There were 13 sepsis events in group 1 (1.4%) and none in group 2 (p = 0.027). Clavien-Dindo Grade I-III complications occurred in 25 (2.7%) and 7 (2.1%) patients in groups 1 and 2, respectively (p = 0.505). Standard antibiotic prophylaxis (PO fluoroquinolone and IM gentamicin) was given in 80% and 86% of patients in groups 1 and 2, respectively (p = 0.030). Subset analysis limited to patients who received standard prophylaxis showed a significant difference in sepsis rates (1.5% vs 0%; p = 0.036).<BR><B>CONCLUSIONS: </B>Adoption of isopropyl alcohol needle washing was associated with a significant decrease in PBS events.